IN NETWORK. If my treating dentist is in-network with my dental insurance plan, I will be billed pursuant to the terms of my insurance policy and my dentist’s contract with the insurer. Even when the practice and my treating dentist are a participating provider with my insurance, I understand that the practice may hold me responsible and collect all charges in any one of the following situations: ● When I choose to have a service that my dental plan covers but I do not obtain the required referral or prior authorization from my health plan. ● When I choose not to use my dental plan and agree to pay for services myself. ● When I receive services that are not covered under my dental plan
IN NETWORK. Premium is the Commercial Plan Premium, as defined in Product Attachment A, billed or accounted for by PacifiCare for coverage of In-Network Services under the PacifiCare Commercial POS Plan.
IN NETWORK. United Health Care participating providers accept fees as payment in full and agree not to bill members for any remaining balances. Members are responsible only for stated co- payments. No claim forms are required to be completed by plan members. Benefits are paid using Reasonable and Customary (R&C) guidelines. R&C refers to charges or fees of a physician which are frequently determined by set services offered over a period of time within a specific geographic area. Fees charged by non- participating providers in excess of R&C limits will be the employee's responsibility and do not help satisfy out-of-pocket limits or deductibles. Any claim form required to be filed will be the plan participant's responsibility. This Benefit Summary is intended to be a brief description of health care benefits available for employees and eligible dependents. More detail is provided in your plan booklet.
IN NETWORK. If I am in your insurance network, you are expected to pay the fee required by your insurance company at the time of service. If benefits have not been verified, you will be expected to pay the full service fee (listed above). You are responsible for knowing the details of your insurance coverage and obtaining authorizations as required by your health plan. I will file with your insurance carrier, however you will want to call and verify your mental health coverage prior to your appointment. The policies and procedures of your insurance health plan will govern fees and payment of fees for professional services. All fees that are not covered by your insurance carrier are your responsibility. *Please note that most insurance companies DO NOT cover marriage therapy and you will be required to pay the full fee of $150.00 per 55-minute session.
IN NETWORK. PREMIUM is the Commercial Plan Premium, as defined in Product Attachment A, billed or accounted for by PacifiCare for coverage of In-Network Services under the PacifiCare Commercial POS Plan.
IN NETWORK. Medical Provider An in-network medical provider is one contracted with the insured person’s policy to provide services to policy members for specific pre-negotiated rates.
IN NETWORK. If my treating provider is in-network with my health insurance plan, I will be billed pursuant to the terms of my insurance policy and my providers contract with the insurer. Even when the practice and my treating provider are a participating provider with my insurance, I understand that the practice may hold me responsible and collect all charges in any one of the following situations: ● When I choose to have a service that my health plan covers but I do not obtain the required referral or prior authorization from my health plan. ● When I choose not to use my health plan and agree to pay for services myself. ● When I receive services that are not covered under my health plan
IN NETWORK. The term “In-Network” is defined as the use of a covered primary care provider or other covered provider who participate in the network such that all claims incurred by such a provider will be processed under the “In-Network” benefit level as described in the applicable Schedule of Benefits. Blue Choice New England Plan 2 uses the term “pcp/plan approved benefits” in a manner similar to in- network.
IN NETWORK. (Contracted) Services
2.15.2.4.1 Out-of-Network and Out-of-State Providers
IN NETWORK. When You receive In-Network Covered Services, You are responsible only for the applicable Copayment, Deductible, and/or Coinsurance amounts noted in Your Schedule of Benefits, Covered Services, and Exclusions. For the most up-to-date Provider information, you may contact the CHL Customer Service Department or access Our website at xxx.xxxxxxxxx.xxx. Emergency Services Urgent Care provided outside the Service Area Services Authorized in advance by CHL If You receive Covered Services from a Non-Participating Provider, You are responsible for the Copayment, Deductible, and/or Coinsurance amounts noted in Your Schedule of Benefits, Covered Services, and Exclusions, plus any amount in excess of the Out-of-Network Rate (“ONR”). Please see Section 1.8 for more information on the Out-of Network Rate.
